Nursing Elites

1. A young man has received a diagnosis of androgen deficiency and has been prescribed testosterone. At clinic follow-up appointments, the nurse should prioritize which of the following assessments?

• A. Bladder ultrasound and urine testing for glucose and ketones
• B. Weight and measurement of blood pressure
• C. Hearing assessment and abdominal girth measurement
• D. Deep tendon reflexes and random blood glucose testing

Correct answer: B

Rationale: In a patient receiving testosterone therapy for androgen deficiency, monitoring weight and blood pressure is crucial. Testosterone therapy can lead to weight gain and hypertension, making regular assessments of these parameters important to detect and manage any adverse effects. Choices A, C, and D are not the priority assessments for a patient on testosterone therapy. Bladder ultrasound and urine testing for glucose and ketones, hearing assessment and abdominal girth measurement, and deep tendon reflexes and random blood glucose testing are not directly related to the common side effects or monitoring requirements of testosterone therapy.

2. A nurse is educating a client with peripheral artery disease (PAD). Which statement made by the client indicates a need for further teaching?

• A. I should avoid walking for long periods to prevent leg pain.
• B. I should inspect my feet daily for any sores or wounds.
• C. I should wear compression stockings to improve circulation.
• D. I should avoid smoking to prevent further damage to my arteries.

Correct answer: A

Rationale: The correct answer is A. Walking is crucial in improving circulation in peripheral artery disease; therefore, the client should not avoid walking for long periods. Choices B, C, and D are correct statements for a client with PAD. Inspecting feet daily helps in early detection of sores or wounds, wearing compression stockings improves circulation, and avoiding smoking helps prevent further damage to arteries in PAD.

3. A 30-year-old woman is taking an oral contraceptive and is concerned about the potential side effects. What should the nurse include in the patient education?

• A. Oral contraceptives can cause weight loss and increased energy levels.
• B. Oral contraceptives can cause increased appetite and weight gain.
• C. Oral contraceptives can cause headaches and breast tenderness.
• D. Oral contraceptives have no side effects.

Correct answer: C

Rationale: The correct answer is C: 'Oral contraceptives can cause headaches and breast tenderness.' It is essential for the nurse to educate the patient about common side effects of oral contraceptives, such as headaches and breast tenderness. Choices A, B, and D are incorrect. Weight loss and increased energy levels (Choice A) are not common side effects of oral contraceptives. Similarly, increased appetite and weight gain (Choice B) are not typical side effects. Finally, stating that oral contraceptives have no side effects (Choice D) is inaccurate as they can have various side effects, albeit usually mild and manageable.

4. Which of the following conditions is associated with a positive Homan's sign?

• A. Deep vein thrombosis
• B. Peripheral artery disease
• C. Varicose veins
• D. Lymphedema

Correct answer: A

Rationale: A positive Homan's sign is indicative of deep vein thrombosis. This sign is elicited by dorsiflexing the foot of a patient with the knee slightly flexed, resulting in calf pain. Peripheral artery disease (choice B) is associated with decreased blood flow to the extremities, but it does not produce a positive Homan's sign. Varicose veins (choice C) are enlarged, twisted veins that are typically not related to Homan's sign. Lymphedema (choice D) is swelling caused by a lymphatic system blockage or dysfunction and is not linked to Homan's sign.

5. Which disorder is caused by a Staphylococcus aureus organism producing a toxin leading to exfoliation and large blister formation?

• A. Herpes simplex I virus
• B. Bullous impetigo
• C. Necrotizing fasciitis
• D. Cellulitis

Correct answer: B

Rationale: Bullous impetigo is the correct answer because it is caused by a Staphylococcus aureus toxin that leads to exfoliation and the formation of large blisters. Herpes simplex I virus (Choice A) causes cold sores and is not associated with exfoliation and blister formation. Necrotizing fasciitis (Choice C) is a severe skin infection involving the deeper layers of skin and subcutaneous tissues, typically caused by bacteria such as Streptococcus or Clostridium species, not Staphylococcus aureus. Cellulitis (Choice D) is a common bacterial skin infection, but it does not involve exfoliation and blister formation as seen in bullous impetigo.

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